drug that fixes atazanavir problem

Jan 25, 2004

Dr. Young,

Are researchers working on some drug that fixes the flaw in atazanavir. For instance, you take it and can be assured the yellowing effect permanently reverses. If they are not, this might be a great idea. What do you think?

Neil

Response from Dr. Young

Thanks for your question.

Elevations in the blood chemical bilirubin occur very commonly among person who take the new protease inhibitoratazanavir (Reyataz). Very significant elevations can occur in about a third of persons who take the drug "unboosted" and nearly half of persons who take the drug "boosted", with ritonavir.

Fortunately, the clinical "yellowing", or jaundice, that you refer to, occurs much less frequently, in only about 10% of persons who take atazanavir.

There is no drug or strategy to reduce the severity of jaundice-- indeed, it is not recommended that the dose of atazanavir be changed or reduced. For persons who have significant jaundice on atazanavir, an alternative protease inhibitor, like fosamprenavir (Lexiva) or Kaletra might be suitable alternatives.

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